User Manual

Monitoring
3-18 LIFEPAK 20e Defibrillator/Monitor Operating Instructions
Respiratory Baseline. Elevation of the waveform baseline (I–II segment) usually represents
rebreathing CO2. This elevation usually is accompanied by gradual increases in the EtCO2
value. Rebreathing CO2 is common in circumstances of artificially produced increased dead
space and hypoventilation. Precipitous rises in both baseline and EtCO2 values usually indicate
contamination of the sensor.
Expiratory Upstroke. In the normal waveform, the rising phase (II–III segment) is usually steep.
When this segment becomes less steep, CO2 delivery is delayed from the lungs to the sampling
site. The causes of this delay can be physiologic or mechanical and include bronchospasm,
obstruction of the upper airway, or obstruction (or kinking) of an endotracheal tube (ETT).
Expiratory Plateau. The plateau of the waveform, which represents the remainder of expiration
(III-IV segment), should be nearly horizontal. The end of the plateau represents the EtCO2 value.
Upward slanting of the expiratory plateau occurs when there is uneven emptying of the alveoli.
Similar to the diminished slope of the Expiratory Upstroke, this pattern can occur in asthma,
chronic obstructive pulmonary disease (COPD), partial upper-airway obstruction, or partial
mechanical obstruction such as a partially kinked ETT.
Inspiratory Downstroke. The fall to baseline (IV-V segment) is a nearly vertical drop. This slope
can be prolonged and can blend with the expiratory plateau in cases of leakage in the exhale
portion of the breathing circuit. The peak EtCO2 value (IV) is often not reached. Relying on the
numeric end-tidal value without observing the breathing waveform may obscure the presence of
a leak.
EtCO2 Monitoring Procedure
The EtCO2 monitor is activated when the FilterLine set is attached. Initialization, self-test, and
warm-up of the EtCO2 monitor is typically less than 30 seconds, but may take up to two and
one-half minutes.
Carefully read the Instructions for Use that are provided with the FilterLine for placement
instructions, use instructions, warnings, cautions, and specifications.
To monitor EtCO2:
1 Press
ON.
2 Select the appropriate EtCO2 accessory for the patient.
Note: To decrease the likelihood of the FilterLine connection coming loose during use,
hand-straighten the tubing after removal from the package before connecting to patient or
device.
CAUTION!
Possible equipment damage.
Failure to replace a broken or missing CO2 port door may allow water or particulate
contamination of the internal CO2 sensor. This may cause the CO2 module to malfunction.
Possible equipment damage.
Do not use excessive force when connecting the FilterLine to the CO2 port. This may damage
the connector.